Beta Thalassemia minor and its impact on glucose metabolism during pregnancy: a retrospective study to assess implication for mothers and offspring

Background: Beta Thalassemia represents one of the most common autosomal recessive disorders worldwide. It is caused by a reduced (beta⁺) or absent (beta°) synthesis of the beta globin chains of the hemoglobin (HbA1) tetramer, that leads to an impaired erythropoiesis. Beta thalassemia patients have higher risk of impaired glucose tolerance (IGT) and diabetes mellitus (DM) as a consequence of the chronic iron-mediated oxidative stress, which ultimately leads to pancreatic dysfunction. The implications of thalassemia (minor or major) on glycemic variability have been extensively studied in non-pregnant individuals, however, clinical data during pregnancy and possible implications for the offspring are sparse. This study aims to provide a retrospective analysis of maternal glucose metabolism during pregnancy in women affected by beta thalassemia (minor or major) as compared to age and BMI matched controls pregnant women without thalassemia.

Methods: This study is designed as a retrospective single-center observational study with two parallel groups including a total of 160 females (n = 80 affected by beta thalassemia and n = 80 controls without history of beta thalassemia). Patients were selected through a systematic research in the telematic database (Viewpoint) of the Department of Gynecology and Obstetrics within all inpatient pregnant women who attended the clinic between January 2008 and August 2019. Maternal parameters (age, BMI, type of thalassemia, need of blood transfusions, chelation therapy, history of miscarriage, preexisting diabetes, OGTT values, tocolysis, corticosteroids for fetal lung maturation) and offspring parameters (gestational age at birth, weight at birth, length at birth, umbilical pH at birth, Apgar Score, need of neonatal intensive care, thalassemia test of the newborn, blood glucose test at birth) were collected. The t Student Test was used in order to represent the magnitude of effect of the thalassemia trait on the glucose metabolism parameters. Furthermore, the t Student Test was used in order to represent the magnitude of effect of the thalassemia trait on the fetal macrosomia. In order to minimize the confounder effect of maternal BMI, a logistic regression was performed.

Results: This work is currently in progress. Statistic will be calculated shortly, we hope to present our results in June.

Conclusion: A risk stratification for gestational diabetes in patients with beta thalassemia or beta thalassemia trait was performed.

Interessenkonflikt

The authors have no conflict of interest.

Publication History

Article published online:
02 June 2020